AccountId: 011433970860
ContactId: ed70e7bd-2378-46bd-baee-7bcd61f1b2ea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 645309 ms
Total Talk Time (AGENT): 212009 ms
Total Talk Time (CUSTOMER): 278327 ms
Interruptions: 5
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/ed70e7bd-2378-46bd-baee-7bcd61f1b2ea_20250124T14:45_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, I said, I'm sorry, did you say [PII] or [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], thank you. Um, my name is [PII]. I'm calling from Fortune Insurance. Um, I was working with [PII] on a billing issue for our client Centurion Restaurant Group. Um, they had, uh, they have two plans and for open enrollment there was some changes, but it looks like the, uh, uh.
[CUSTOMER][NEUTRAL] The bottom line, there's like 5 employees that are on the buy up um gap plan through APL, but they're getting charged for the premium of the lower APL gap option and she was researching that for me. I had shared with her the.
[CUSTOMER][NEUTRAL] The um detailed group report that's available through the portal and I showed her um where it shows on the report that they're on the correct benefit but being billed the wrong premium. um I was wondering if I could speak with her or if you could help me uh with the status on this research that was being done.
[AGENT][NEUTRAL] Let's see if she is available in that way, since she's aware of what's going on. And you said your name is [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you. And you are with Fortune Insurance?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that was regarding the Centurion.
[CUSTOMER][NEUTRAL] The Centurine Restaurant Group.
[AGENT][NEUTRAL] OK, bear with me just one second. I'm seeing if she's available.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] See if she answers.
[AGENT][NEUTRAL] What is the group number for the Centurion? Do you have that available?
[CUSTOMER][NEUTRAL] Yes, 21471.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] It may just take her a minute if or um.
[AGENT][NEUTRAL] Just checking to see if she is in.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But in case she's not, you're stating there 5 employees they're they're not being charged for the plan that they should be being in charge, is that what I'm hearing?
[CUSTOMER][NEUTRAL] Yeah, and it's a little bit more uh deeper than that in the aspect that even though the if you look like online and if you look like on the on the group detail report that's available from the portal, it's showing uh so they have two benefits one has a $5000 inpatient and the other one has a $4000 inpatient.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, if you look on the report, it shows that they're on the correct 5000 inpatient benefit, but when you call, I mean sorry, when you call APL for benefits when the providers verify benefits, it's quoting the plan with the 4000 instead of the 5000 so something there is funky.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 400.
[AGENT][NEUTRAL] We don't like Funky do we.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Do you have one of those policy numbers available? Let me look at something. I'm waiting to see if she's available.
[CUSTOMER][NEUTRAL] I do. Yeah, I do. Hold on, let me, let me.
[CUSTOMER][NEUTRAL] And then the thing, the, the, the more um critical part of this is that the HR director, that's one of the decision makers, is one of the ones that's being impacted by this. Yeah, and she's pregnant and she's about to go into labor, so.
[AGENT][NEGATIVE] Oh no, that's not good. Oh no.
[AGENT][NEUTRAL] No, we need to get this we need to get this right quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If you've got one of those policy numbers. I just want to see if maybe they're
[CUSTOMER][NEUTRAL] Um, alright, let me see. Yeah, I, I'm, I, I'm, I'm, I'm trying to look it up. OK, [PII], let me pull up the detail report because I believe that has the policy number on it.
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] Here we go.
[CUSTOMER][NEUTRAL] It'll be another uh few seconds. OK, let me see here.
[AGENT][POSITIVE] Not a problem. You take your time.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Alright, here she is. Her policy number is 2273102.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Kind of weird too because um this group is set up on EDI feeds and I don't know how this didn't error out.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] I'll tell you what, uh, [PII] is not answering you, but someone in broker resources should be able to assist you further.
[AGENT][NEUTRAL] Would that be OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[AGENT][POSITIVE] All right. Thank you. Well, it's been a pleasure to talk to you, [PII]. If you'll hold one moment, please, ma'am.
[CUSTOMER][POSITIVE] Likewise, have a lovely weekend.
[AGENT][POSITIVE] You too. Thank goodness it's Friday, right?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Yes, thank goodness it's right.
[AGENT][NEUTRAL] Well, hold just one moment please, ma'am.
[CUSTOMER][POSITIVE] All righty. OK, thanks. Bye.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], it's Alicia care team. How are you doing?
[CUSTOMER][NEUTRAL] I'm doing fine [PII] how are you?
[AGENT][POSITIVE] Yeah, I'm doing well, thank you. Listen, I have uh [PII] with Fortune Insurance on the line.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] She was calling on group number 21471 with the Centurion Restaurant Group.
[CUSTOMER][NEUTRAL] 21471.
[AGENT][NEUTRAL] She
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And she said that [PII] was looking into something for her. She's got about 4 or 5 employees or employees on the group that were not switched to the 5000 plan.
[AGENT][NEUTRAL] And one of them is the HR.
[AGENT][NEUTRAL] For the group and she's pregnant and getting the $4000 benefits when they're calling in for benefits.
[AGENT][NEUTRAL] And so I, I am [PII] I'm sure she's busy.
[CUSTOMER][NEUTRAL] She's not, no, she's not on until [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] I got you.
[AGENT][NEUTRAL] Um, she asked to speak to her since she knew what was going on, but can you assist her further?
[CUSTOMER][NEUTRAL] I can certainly try. Oh, Barb's on now.
[CUSTOMER][NEUTRAL] Hang on, let me see if she's available.
[CUSTOMER][NEUTRAL] What is um the person that they're looking for?
[AGENT][POSITIVE] So I do have a policy number 2273102 for [PII]. She's the great contact.
[CUSTOMER][NEUTRAL] She's on the 5000.
[AGENT][NEUTRAL] I've got on 4000.
[AGENT][NEUTRAL] When I pull her policy up.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It's showing 5000.
[CUSTOMER][NEUTRAL] If you look at 227-3102.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's a $5000 plan.
[AGENT][NEUTRAL] And then when I go to the benefits, it says for the inpatient is 4000.
[AGENT][NEUTRAL] What?
[AGENT][NEUTRAL] What, how are you seeing, what, what screen are you in? Let me ask you that because you may, I'm on a claim screen.
[CUSTOMER][NEUTRAL] I'm just
[CUSTOMER][NEUTRAL] Yeah, so when you just pull it up in GRPIQ.
[CUSTOMER][NEUTRAL] Go to her name.
[AGENT][NEGATIVE] There is a an issue there, in there.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] It looks like they got partway through it and didn't finish it out.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Just let [PII] know that I'll get with our customer service. We'll get that fixed today.
[AGENT][POSITIVE] OK, I will. Thank you. I appreciate it. You have a great day and happy Friday.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Uh-huh, bye.
[AGENT][NEUTRAL] Yeah, thanks. Bye-bye.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you for your patience. I did speak with [PII] in Broker Resources. We looked at that and we see the issue and she says she's gonna get with customer service and get that fixed today.
[CUSTOMER][POSITIVE] Oh, awesome. OK, do you need me to forward you the 5 folks that are being affected by that?
[AGENT][NEUTRAL] If you want to email that to our care team, they can forward that to the customer service team to.
[CUSTOMER][NEUTRAL] OK. OK. Um, all right, perfect. So it's the, the regular, um,
[AGENT][NEUTRAL] Review that
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] It's
[AGENT][NEUTRAL] Care team at [PII].
[CUSTOMER][NEUTRAL] PT I got it. It's on my Outlook already there. I, I, I communicate with you guys often. We have a lot of groups with APO.
[AGENT][NEUTRAL] I thought I noticed your name.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] All right, and thank you so much. I hope you have a great rest of your day and a lovely weekend, OK?
[AGENT][POSITIVE] I hope you do too, and it's been such a pleasure to assist you. And thank you, [PII], for calling APL. Take care. Bye-bye.
[CUSTOMER][NEUTRAL] Likewise. OK, bye.